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Nasopharyngeal Carcinoma (IJNPC) Vol International Journal of Nasopharyngeal Carcinoma (IJNPC) Vol. 03, No. 02, June 2021 | 51-53 International Journal of NASOPHARYNGEAL CARCINOMA Journal homepage: https://talenta.usu.ac.id/IJNPC New Role Management Nasopharyngeal Carcinoma Patient in General Hospital Haji Adam Malik Medan during COVID-19 Pandemic Sholahuddin Adlan Simatupang1*, Farhat Farhat1, Elvita Rahmi Daulay2 1Departement of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia 2Departement of Radiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia Abstract Article Info Introduction: Nasopharyngeal carcinoma (NPC) is a type of squamous cell carcinoma that develops Article history: from the nasopharyngeal epithelial cells and has become one among the most popular frequent Received: 7th June 2021 malignancy in the head and neck. When patients with cancer are diagnosed with COVID-19, more Received in revised form: 17th June 2021 intense surveillance or treatment should be considered. Accepted: 17th June 2021 Discussion: In the COVID 19 pandemic, Personal protection provisions should be strengthened. created for cancer patients and cancer survivors. To avoid the spread of COVID-19, many improvements have Keywords: been made in the treatment of NPC patients at the Haji Adam Malik General Hospital in Medan. Nasopharyngeal carcinoma, management, Conclusion: The management carried out on NPC patients, there are several examinations that the COVID-19, Adam malik patient needs to do first in the COVID 19 pandemic at the General Hospital Haji Adam Malik Medan. *Corresponding author: Address: Jl. Dr. Mansyur No.5, Padang Bulan, Kec. Medan Baru, Kota Medan, Sumatera Utara 20155, Indonesia e-mail: [email protected] 1. INTRODUCTION The treatment parameters were abstracted and summarized consisting Nasopharyngeal carcinoma (NPC) is a malignancy neoplasm that of use of the rescue operation and the type of surgical approach, the method, occurs in the epithelial layer of the Nasopharynx [1]. NPC is a common the dose and the fractionation of the re-irradiation, as well as the data on kind of head and neck cancer that develops in the pharyngeal recess grave (grade 3) toxicity [2]. (fossa of Rosenmüller) or the posterolateral nasopharynx [2]. In terms In General Hospital Haji Adam Malik Medan, management performed of epidemiology, etiology, a clinical attitude, reaction to treatment and for NPC is surgery, chemotherapy and radiotheraphy. prognosis, it differs greatly from other head and neck tumors. In 2018, a total of 129,000 events reported around the world, with 73,000 deaths. 2. MAIN TEXT [3]. Although the NPC is unusual in the United States and Europe, it is Comprehensive risk / benefit analysis must be carried out prior to endemic in Southeast Asia, North and Arctic Africa, with the endemic initiation of oncological treatment, especially in elderly patients with form with the infection before the old Epstein-Barr virus (EBV) and a comorbidities that are candidates for the treatment of immunocontrolling not differentiated not keratinizing squamous cell carcinoma (WHO type point inhibitor. Any patient (especially if they have cancer) who has flu-like III) as a prevailing histology [2, 4]. symptoms, severe breathing problems, or sudden kidney failure, should be The Covid-19 disease has become an unavoidable disease all over treated as a patient with COVID-19. Even if nasopharynx smears are the world since February 2020, which was first from Wuhan (China) consistently negative, labor indications showing infections and radiographic [5]. Serious respiratory residual syndrome, corona virus 2 (SARS-COV- signs of pneumonia should be treated as COVID-19. This is necessary to 2) is guilt, although little is known about virus action modes or potential avoid underestimating the number of patients who are positive even infect treatments [6]. Although in a new study showing the fact that SARS- others and increase our capacity for recognize the infection of COVID-19 CoV-2 in wastewater before this date, at the same time in various in patients with cancer [9]. regions, changed the understanding of the spread of the virus in Italy, the first confirmed case of Covid-19 in Italy was documented on February 21 2020, from Cutogno (Lombardei), although a recent study 2.1 Surgical Treatment during the COVID-19 Pandemic revealed the presence of SARS COV-2 in wastewater before this date, Generally corrective treatment of any cancer is not difficult to simultaneously in different regions, causing the understanding of virus understand, but it is more than that for the framework of medical care, with proliferation in Italy to change [7 , 8]. doctors and other health care providers in the important part. The current Positive SARS COV 2 was confirmed on a nasopharyngeal swab, COVID-19 pandemic is a vivid example of a situation where even although there is growing evidence that clinical signs of disease can occur developed countries with modern and advanced healthcare systems can even if the swab is negative, and that the presence of disease cannot be quickly become resource-limited situations. [2]. detected if the patient dies prematurely. Patients with COVID-19 positive Severe acute respiratory syndrome caused by coronavirus 2 (SARS- cancer have a poor prognosis. worse than negative Covid-19 cancer patients, CoV-2), was first discovered in China in 2019. It's mostly seen in the and doctors generally prove a dramatic clinical course in patients with no mucosa of the upper respiratory system, notably the nasopharynx [15] [16]. proof of infection [9, 10]. Fourteen days are required before surgical resection of the Radiotherapy and systemic treatment are two of the most common nasopharynx, all patients should be isolated at home or hospitalized treatments for nasopharyngeal carcinoma (NPC). For individuals with if possible to qualitatively detect nucleic acids from SARS-CoV-2, locally advanced disease, it is usually recommended to receive two real-time reverse transcription polymerase chain reaction (RT- chemotheraphy nd radiotherapy on time. There is a relationship between PCR) assays must be performed within 24 hours. Surgery can be delaying treatment with worsening clinical outcome [11-14]. performed with conventional precautions if the subject's symptoms are absent after 14 days of isolation or quarantine or if two different Copyright © International Journal of Nasopharyngeal Carcinoma Published by Talenta Publisher, ISSN: 2656-9027 e-ISSN: 2656-9035 DOI: 10.32734/ijnpc.v3i02.6320 51 International Journal of Nasopharyngeal Carcinoma (IJNPC) Vol. 03, No. 02, June 2021 | 51-53 negative rRT-PCR results [17-19]. The medical clinic disease be possible to establish diverse tactics based on the importance of anti-tumor control group, in participation with microbiologists and doctor, therapy [24]. should advice the further administration of patients who tried Such as the handling of NPC with surgery and radiotherapy, positive for COVID-19. It's proposed that medical procedure be chemotherapy during the COVID-19 pandemic at Haji Adam Malik deferred up till side effects have settled and two distinct RT -PCR Hospital in Medan, a chest X-ray and antigen swab must be carried out one tests have stayed no virus found in the body. According to certain day before chemotherapy is given. If the chest photo of a patient for creators, 12 weeks of hanging time is appropriate for patients chemotherapy shows signs of suspicion of COVID-19, chemotherapy is suffering from NPC during the COVID-19 pandemic [2]. postponed, and the patient is subjected to self-isolation or treatment for In General Hospital Haji Adam Malik Medan, NPC patients who COVID-19 first. require previous surgery must have a chest x-ray and PCR swab done one day before surgery. If the result is positive and there are no 3. CONCLUSION symptoms, the patient must self-isolate at home for 14 days. However, if the patient has symptoms of COVID-19, the patient is admitted to In the management of NPC at Haji Adam Malik General Hospital, the hospital for treatment. Medan, a chest X-ray and a PCR swab should be performed one day before surgery, and a chest X-ray and an antigen swab should be performed before 2.2. Radiotherapy during the COVID-19 Pandemic chemotherapy. But in radiotherapy, there is no specific procedure for the prevention of COVID-19. A large number of papers in the COVID-19 pandemic advocate the use of hypofractionated radiation therapy to protect treatment capacity from understaffing, and to reduce the likelihood of infection REFERENCES of SARS-CoV-2 patients from daily hospital visits (lower fraction [1] Yavuz A, Ağralı ÖB, Çalışkan ZL, Türkaydın D, Sertgöz A, Kuru B, number with larger dose) [20-23]. Doğan B. Multidisciplinary treatment approach in a patient with Despite the fact that hypofractination schemes have been history of nasopharyngeal carcinoma. Case reports in dentistry. 2014 presented for patients with head and neck cancer, according to the Jan 9;2014. DOI: https://doi.org/10.1155/2014/918461 ASTRO-ESTRO Consensus Statement published in July 2020, the [2] Svajdova M, Sicak M, Dubinsky P, Slavik M, Slampa P, Kazda T. minimum currently acceptable number of fractions for curative-intent Recurrent Nasopharyngeal Cancer: Critical Review of Local treatments employing IMRT is 20. [22]. However, if feasible and Treatment Options Including Recommendations during the COVID- justified, referring the patient to mini-invasive endoscopic surgery 19 Pandemic. Cancers. 2020 Dec;12(12):3510. DOI: would have the benefit of reducing the number of visits to the hospital https://doi.org/10.3390/cancers12123510 and reducing the danger of cross-contamination. [2]. [3] Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. After the COVID-19 the average time spent waiting for an Global cancer statistics 2018: GLOBOCAN estimates of incidence outbreak for radiotherapy was considerably greater in the case of and mortality worldwide for 36 cancers in 185 countries. CA: a cancer patients who did not get extra chemotherapy rounds.
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